皮质下缺血性血管病局部脑血流量的变化  

Change of Regional Cerebral Blood Flow in Subcortical Ischemic Vascular Disease

作　　者：舒敏[1] 章军建[1] 高永哲[1] 吴光耀[2] 

机构地区：[1]武汉大学中南医院神经科,湖北武汉430071 [2]武汉大学中南医院放射科,湖北武汉430071

出　　处：《武汉大学学报（医学版）》2014年第4期572-576,共5页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:30970962)

摘　　要：目的:研究皮质下缺血性血管病(SIVD)患者局部脑血流量(rCBF)的改变,并探讨其与认知功能损害的关系。方法:采用动脉自旋标记(ASL)磁共振灌注技术定量测定32例SIVD患者与21例正常对照组额叶、颞叶、顶叶及枕叶皮质、白质的rCBF;采用蒙特利尔认知评估量表(MoCA)中文版对SIVD与正常对照组进行认知功能总体评估。结果:①SIVD患者额叶、颞叶、顶叶及枕叶皮质、白质的rCBF均降低;②SIVD组有认知功能损害患者和无认知功能损害患者相比额叶和顶叶皮质rCBF降低;③MoCA评分与额叶、颞叶及顶叶的皮质、白质rCBF相关。结论:SIVD患者脑皮质及白质均存在rCBF的下降,额叶及顶叶皮质rCBF的下降与认知功能损害有关。Objective： To study the change of regional cerebral blood flow （rCBF） in subcortieal ischemic vascular disease （SIVD）, and its relationship to cognitive impairment. Methods： Thirty-two SIVD patients and 21 normal subjects as control group underwent arterial spin-labeling （ASL） MR imaging to obtain absolute rCBF in cortex and white matter of frontal lobes, temporal lobes, parietal lobes and occipital lobes. Cognitive test of all subjects was performed with Montreal cog- nitive assessment （MoCA）. Results： （1）Compared with controls, the patients with SIVD had reduced rCBF in cortex of frontal lobes （10.6%, P〈0.01）, temporal lobes（4.3%, P〉0.05）, parietal lobes（12.8%, P〈0.01）, occipital lobes （9.6%, P（0.01）, white matter of frontal lobes （18.5%, P〈0. 001）, temporal lobes （15.6%, P〈0.01）, parietal lobes （30.5%, P〈0.01）, and occipital lobes （12.7 %, P〈0.01）. （2）The rCBF in the SIVD patients with cognitive impairment decreased by 7.4%（P〈0.05）in frontal cortex and by 7.6% in parietal cortex （P（0.05） when compared with the patients without cognitive impairment. On the other hand, no such changes were found in white matter, temporal lobe and parietal lobe. （3）The MoCA score was positively related with the rCBF of the frontal cortex（r=0. 351, P〈0.05）, frontal white matter （r=0. 382,P〈0.01） ,temporal cortex（r=0. 426,P〈0.01）, temporal white matter （r=0. 354,Pd0.01）, parietal cortex （r=0. 454,P〈0.01）, and parietal white matter （r=0. 457,P〈0. 01）, respectively. Conclusion： These results showed that rCBF decreased significantly in cortical gray matter and white matter in elderly patients with SIVD. Also the reduction of rCBF in the frontal and parietal cortex was associated with cognitive impairment.

关 键 词：皮质下缺血性血管病 脑血流量 磁共振成像 动脉自旋标记 灌注 认知功能损害 

分 类 号：R743.31[医药卫生—神经病学与精神病学]